PMID- 36588396
OWN - NLM
STAT- MEDLINE
DCOM- 20230216
LR  - 20230303
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 98
IP  - 3
DP  - 2023 Mar
TI  - Thrombosis in multiple myeloma: Risk estimation by induction regimen and 
      association with overall survival.
PG  - 413-420
LID - 10.1002/ajh.26806 [doi]
AB  - Lenalidomide-containing (R) triplet and quadruplet regimens are the standard of 
      care for multiple myeloma (MM) and have been shown to increase the risk of 
      thrombosis. The association between thromboembolism (TE) and survival in the 
      novel multidrug era is not yet delineated. In this study, we evaluated the 
      incidence of TE during the first year of MM diagnosis, its association with the 
      type of induction regimen, and its impact on overall survival. We studied 672 
      newly diagnosed MM (NDMM) patients who received a triplet or quadruplet 
      lenalidomide-based induction at the Mayo Clinic, Rochester. TE was diagnosed in 
      83 patients (12.4%). Of these, 56 (8.3%) had a deep venous thrombosis (DVT), 23 
      (3.4%) had a pulmonary embolism (PE) with or without the DVT, and 4 (0.6%) 
      patients had a stroke. Carfilzomib-Rd (KRd) had the highest risk of TE (21.1%, 
      18/85), followed by quadruplets (11.1%, 5/45), bortezomib-Rd (9.6%, 51/531), and 
      0/11 (0%), treated with other lenalidomide-containing regimens. The difference in 
      TE risk between KRd and the other regimens was statistically significant 
      (OR = 2.6, p < .01). Nine patients developed a TE before being exposed to any 
      treatment. Survival was significantly lower among patients that developed a TE 
      (66 vs. 133 months, p < .01). The association of TE with reduced survival 
      demonstrated in univariate analysis (HR = 2.2, 95% CI = 1.6-3.3) was maintained 
      in the multivariable analysis adjusted for high-risk interphase fluorescence in 
      situ hybridization (FISH), sex, age, receipt of an upfront transplant, the 
      response at induction, and the International Staging System (ISS) (HR = 2.61, 
      CI = 1.74-3.9). We conclude that TE is an important aspect of MM management, and 
      effective management is especially relevant in the novel treatment era.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Charalampous, Charalampos
AU  - Charalampous C
AUID- ORCID: 0000-0003-3617-3141
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Goel, Utkarsh
AU  - Goel U
AUID- ORCID: 0000-0003-1663-0325
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Kapoor, Prashant
AU  - Kapoor P
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Binder, Moritz
AU  - Binder M
AUID- ORCID: 0000-0001-9014-9658
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Buadi, Francis K
AU  - Buadi FK
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Dingli, David
AU  - Dingli D
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
AUID- ORCID: 0000-0001-8780-9512
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Fonder, Amie L
AU  - Fonder AL
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Gertz, Morie A
AU  - Gertz MA
AUID- ORCID: 0000-0002-3853-5196
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Gonsalves, Wilson
AU  - Gonsalves W
AUID- ORCID: 0000-0001-6890-969X
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Hayman, Suzanne R
AU  - Hayman SR
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Hobbs, Miriam A
AU  - Hobbs MA
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Hwa, Yi L
AU  - Hwa YL
AUID- ORCID: 0000-0002-8163-2979
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Kourelis, Taxiarchis
AU  - Kourelis T
AUID- ORCID: 0000-0001-8573-9434
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Lacy, Martha Q
AU  - Lacy MQ
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Leung, Nelson
AU  - Leung N
AUID- ORCID: 0000-0002-5651-1411
AD  - Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo 
      Clinic, Rochester, Minnesota, USA.
FAU - Lin, Yi
AU  - Lin Y
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Warsame, Rahma
AU  - Warsame R
AUID- ORCID: 0000-0003-0240-0326
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Kyle, Robert A
AU  - Kyle RA
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Rajkumar, S Vincent
AU  - Rajkumar SV
AUID- ORCID: 0000-0002-5862-1833
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Kumar, Shaji
AU  - Kumar S
AUID- ORCID: 0000-0001-5392-9284
AD  - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      Minnesota, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230101
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
RN  - F0P408N6V4 (Lenalidomide)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 69G8BD63PP (Bortezomib)
SB  - IM
MH  - Humans
MH  - *Multiple Myeloma/complications/drug therapy
MH  - Lenalidomide/therapeutic use
MH  - In Situ Hybridization, Fluorescence
MH  - Dexamethasone/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Bortezomib/therapeutic use
MH  - *Thrombosis/etiology/drug therapy
MH  - *Thromboembolism/drug therapy
EDAT- 2023/01/03 06:00
MHDA- 2023/02/17 06:00
CRDT- 2023/01/02 02:03
PHST- 2022/10/27 00:00 [revised]
PHST- 2022/09/01 00:00 [received]
PHST- 2022/11/28 00:00 [accepted]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/02/17 06:00 [medline]
PHST- 2023/01/02 02:03 [entrez]
AID - 10.1002/ajh.26806 [doi]
PST - ppublish
SO  - Am J Hematol. 2023 Mar;98(3):413-420. doi: 10.1002/ajh.26806. Epub 2023 Jan 1.